INFECTION CONTROL

INFECTION
CONTROL/PREVENTION
IMMUNITY & DISEASES
IMMUNITY
Immunizations are:
• Artificial defenses that protect against specific
pathogens
• Artificial or weakened antigens that help the body
develop protective antibodies
• Vaccines that can prevent most childhood
diseases such as measles, rubella (German
measles), meningitis, mumps, polio, diphtheria,
chickenpox, whooping cough, and tetanus
IMMUNITY (CONT’D)
Active immunity:
• exposure to a disease organism triggers the
immune system to produce antibodies to that
disease. There are 2 types:
• Natural active: antibodies develop during
infection with the actual disease. (measles,
chickenpox)
• Artificial active: introduction of a killed or
weakened form of disease organism thru vaccines
(MMR, Hep B, polio)
IMMUNITY (CONT’D)
Passive immunity:
person is given antibodies to a disease. There are 2
types:
• Natural passive: mother to child thru placenta or
milk
• Artificial passive: used during potentially fatal
diseases. Provides an instant response of
temporary antibodies (tetanus, gamma globulin)
Protection for active immunity is permanent and
takes several weeks to become active
Passive immunity is temporary and acts
immediately
BACTERIAL/VIRAL
INFECTIONS
Immunosuppression:
Occurs when the body’s immune system is
inadequate. A number of factors can lead to this
condition, including:
• Advanced age and Frailty
• Chemotherapy
• Infection with Human immunodeficiency virus
(HIV)
• Radiation therapy
BACTERIAL INFECTIONS
(CONT’D)
Methicillin-resistant Staphylococcus aureus (MRSA):
Is a virulent staph infection, normally found on
skin and mucous membranes.
Resistant to antibiotic treatment, and can prove
fatal very quickly
Vancomycin-resistant enterococci (VRE):
Entero-cocci are found in the gastrointestinal tract.
Major cause of infections acquired in health care
facilities. Most strains are highly resistant to
many antibiotics.
Newer strains are resistant to vancomycin
BACTERIAL INFECTIONS
CONT’D
Streptococcus A:
• Is a bacterium that produces very powerful
enzymes that destroy tissue and blood cells.
• Infection is pass on to others by coughing or
sneezing, touching environmental surfaces
without washing your hands.
• Strep A infection occurs when bacteria enters the
body through minor trauma or a break in the skin
• Good hand washing helps reduce the risk of
infection.
• Treatment with antibiotics and surgery, the
results are not always good
BACTERIAL INFECTIONS
(CONT’D)
• Clostridium difficile (C.diff) is a bacterium which
causes diarrhea
> develops after a series of antibiotic therapy.
> affects the lining of the intestine, causing
inflammation.
> results in sudden, severe, foul-smelling, watery
diarrhea. More commonly acquired in hospitals
• Escherichia coli: commonly found in the intestinal
tract (feces). A small amt of this bacteria can
contaminate meat, especially ground beef
• Salmonella: a group of bacteria that cause mild
to life threatening intestinal infection (food
poisoning)
BACTERIAL INFECTIONS
(CONT’D)
Precautions:
• Wash your hands regularly with soap and water
before and after patients care, and removal of
gloves
• Wear gloves and gown when coming in contact
with infectious material
• Encourage visitors to wash their hands before
and after patients visit to ensure that they don’t
carry germs
• Carry alcohol wipes and extra gloves to use
between patients
• Remove gown and gloves and dispose of them
appropriately as per policy, outside of patients
room
• Have visitors report to the nurses’ station before
entering room
TUBERCULOSIS
INFECTION
Tuberculosis (TB): is an infectious disease caused
by the organism Mycobacterium tuberculosis
(tubercle bacilli)
• Tubercle bacilli: are spread by airborne droplets
expelled when a person with active TB coughs,
sneezes, or talks
• Individuals exposed to contaminated air may
breathe in the organism. This is more likely to
occur in poorly ventilated or closely confined
spaces (vehicles, trains, crowded areas)
TUBERCULOSIS
INFECTION (CONT’D)
TB: an increase in the number of people
who are at risk, including those who are:
• HIV positive
• Infected but fail to take their meds
• Live in poverty and are malnourished
• Immigrants to the United States from
countries where TB is still common
• Have had inactive TB but have grown
older and experience increased disability
TUBERCULOSIS
INFECTION (CONT’D)
Latent TB:
• An estimate of 10 to 15 million people in the U.S.
have latent TB infection
• A person infected and has a strong immune
system, is able to contain the infection and will
not become ill with the disease.
• Persons are not contagious (cannot transmit TB
infection to others
• Only 1 in 10 persons with latent TB infection will
ever develop active TB, as long as they are HIV
negative
TUBERCULOSIS
INFECTION (CONT’D)
Active TB: occurs when an individual’s immune
system fails to keep the TB organism contained
• Can involve almost any organ in the body, but is
most commonly spread from person to person
when lungs or airways are involved
• Airborne precautions are required (mask,
negative pressure room) until three consecutive
Acid Fast Bacilus (AFB) sputum smears are
negative
TUBERCULOSIS
INFECTION (CONT’D)
• Signs/symptoms of TB: as disease
progresses, the person will show one or
more symptoms:
• Fatigue
• Loss of appetite and weight
• Weakness
• Elevated temp in the afternoon and
evening
• Night sweats
• Spitting up blood (hemoptysis)
• Coughing
TUBERCULOSIS
INFECTION (CONT’D)
TB diagnosis: the presence of TB bacterium in the
body can be shown by:
• A sputum culture: grows the organisms from a
specimen of secretions from the person’s lungs
• Chest X-rays: show the extent of the disease
process in the lungs
• A positive skin test (Mantoux test) shows the
presence of antibodies to the TB organisms in the
body, and is not an indication of the active
disease
• Most health care workers must undergo a skin
test for TB before employment
TUBERCULOSIS
INFECTION (CONT’D)
TB treatment/prevention
• A person with TB is treated with a selected
antibiotic or combination of antibiotics
• Once drug therapy starts, the patient usually
becomes noncontagious (cannot spread the
disease organism) within two to three weeks
• Cure for TB requires 6-12 months, or longer, of
continuous treatment
• The course of treatment must be completed to
avoid recurrence
• All new TB and suspected cases should be
reported promptly to the Health Department by
the health care provider, as required by the state
AIDS AND HIV
• Acquired Immune Deficiency syndrome (AIDS),
which is a serious condition that affects the
body’s ability to fight infections
• AIDS is caused by the Human Immunodeficiency
Virus (HIV)
• HIV in the body, can destroy the immune cells
(T-cells and white blood cells) that defend the
body against infections
• Without these cells, the body cannot defend itself
from illness
• Disease and infections can now move into the
body without a fight
AIDS AND HIV (CONT’D)
HIV can be transmitted by:
• Blood and plasma
• Semen
• Vaginal secretions
• Cerebrospinal fluid
• Bone marrow
• Sharing injection needles or syringes
• Placenta
• Breast milk
• Body fluids containing blood
• Body tattooing/piercing
AIDS AND HIV (CONT’D)
HIV cannot be transmitted by:
• Shaking hands
• Coughing
• A dry kiss
• Swimming pools
• Sharing food
• Donating blood
• Hugging
• Sneezing
• Toilet seats or rest rooms
• Sharing eating or drinking utensils
• Insects, including mosquitos
• Door knobs
• Sweat, saliva, or tears
AIDS AND HIV (CONT’D)
HIV tests and treatment:
• Most widely used test is the enzyme-linked
immunosorbent assay (ELISA) test
• Positive results, the test is repeated. After two
positives, a Western Blot Test is done to confirm
the results
• No cure for AIDS and no vaccine available for
HIV.
• Antiretroviral therapy, which is known as cocktail
drugs, combination therapy, or highly active
antiretroviral therapy (HAART). Each type of drug
fights HIV differently to slow down the spread of
the HIV virus (combivir, invirase, atripla, norvir)
AIDS AND HIV (CONT’D)
Stages of the Disease: Person who is exposed to
HIV develops antibodies to the virus within 2 –
24 weeks (window period)
• Stage 1: Newly exposed persons may exhibit flu
like symptoms that may last one to two weeks
• Stage 11: symptoms such as weight loss, night
sweats, fevers, swollen lymph nodes, dry
persistent cough, oral candidasis (thrush), and
fatigue
• Stage 111: T cell count is below 200/m3
(normal T Cell count in a healthy adult is 800-1000)
Stage 11 symptoms with one or more opportunistic
infections are present
(Kaposi’s Sarcoma, pneumocystis carinni) develops
AIDS AND HIV (CONT’D)
Standard precautions:
• Assume that all blood and bodily fluids are
contagious
• Use appropriate Personal protective Equipment
(PPE) (mask, gown, gloves, or goggles) when
appropriate
• Dispose of blood, body fluids, and contaminated
materials in the appropriate containers such as
(red bags, needle/sharps boxes)
• Do not touch broken glass with your hand. Use
forceps or tongs to dispose of glass
AIDS AND HIV (CONT’D)
Standard precautions:
• Keep all cuts and breaks on skin covered with a
band-aid, and wear disposable gloves
• Disinfect surfaces contaminated with blood or
body fluids using 1:10 bleach solution
• Do not eat, drink, smoke, or apply cosmetics or
lip balms in areas where there may be blood or
body fluids
• Do not store food or drink in refrigerators where
blood or body fluids may be present
• Practice hand hygiene frequently and thoroughly,
even after using gloves
HEPATITIS A
Hepatitis A virus (HAV) is most common and
transmitted by:
• Feces, saliva, and contaminated food
Symptoms: Yellowish color of skin (jaundice) and
sclera, fever, nausea, vomiting, diarrhea, fatigue,
abdominal pain, dark urine, and appetite loss.
respiratory symptoms, rashes, and joint pain
Treatment:
• Vaccine available
• Rarely fatal
• Bedrest and avoidance of alcoholic beverages
Precautions: wash hands before and after handling
food, wash fruits and vegetables thoroughly
HEPATITIS B (CONT’D)
• Hepatitis B virus (HBV)
• Causes inflammation of the liver
• Tissue response to virus may be mild, flu-like, or
so severe as to cause hospitalization
HBV may be present in blood and body fluids such
as:
• Bloody saliva contacted during dental procedures
• Blood
• Semen
• Vaginal secretions
• Cerebrospinal fluid
• Synovial fluid (fluid lubricating the joints)
HEPATITIS B (CONT’D)
Full immunizations:
• Requires three doses of vaccines over a 4–6
month period
• Personnel screened for the hepatitis B surface
antibody, after the immunization is completed
(blood test to determine titer levels)
• Incidence of side effects to the vaccine is very
low
• Effective at providing protection against the Hep
B virus
• Vaccine is available at no cost through the
Employee Health Department
HEPATITIS B (CONT’D)
Accident exposure to blood and body fluids:
• You must be evaluated and treated by the
employee health department within four hours of
exposure
• If the employee health department is closed, you
should go to the emergency room within the
same time frame of less than four hours of
exposure
• Facility will provide upon consent, a confidential
medical evaluation including blood tests, post-
exposure prevention treatment and follow-up
counseling
HEPATITIS C (CONT’D)
Hep C virus (HCV
• Transmitted through blood and blood products
• May be mistaken for the flu
Common signs and symptoms include:
• Fatigue
• Depression
• Fever
• Mood changes
• Weakness
• Pain and Loss of appetite
• May cause liver cancer and liver failure
HEPATITIS C (CONT’D)
Protect yourself by:
• Using standard precautions
• Taking the vaccine, if available
• Practicing safe sex (using condoms)
• Not using illegal drugs
• Giving your full attention to the handling of
sharps such as needles or razors
PREVENTING INFECTION
• Assist patients to maintain adequate fluid intake
• Wipe from front to back when cleaning perineal
area
• Observe patient carefully and report to the nurse:
> changes in frequency of urination
> complaints of pain/burning on urination
> coughing or respiratory problems
> confusion or disorientation that is unusual
> drainage or discharge from any body opening
or wound
> changes in skin color
> complaints of pain, discomfort or nausea
> elevated temp, red, swollen areas on body